Provider Demographics
NPI:1053720102
Name:BERWALD, ALLISON (LCSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BERWALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 STERLING PL
Mailing Address - Street 2:APT. 4C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3343
Mailing Address - Country:US
Mailing Address - Phone:631-827-0203
Mailing Address - Fax:
Practice Address - Street 1:122 STERLING PL
Practice Address - Street 2:APT. 4C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3343
Practice Address - Country:US
Practice Address - Phone:631-827-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-03
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082365-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical